Question:
When will we have a cure for multiple sclerosis?
Expert Answer:
Usually when asked this question I advise patients and families that I don’t expect a cure very soon. The immune system if very complex and it’s hard to reprogram it once it’s gone astray. Recently my answer is changing a little, but only a little. Over the past several years there has been growing interest in doing “stem cell transplantation” in order to replace a defective immune system. I’ve recently become involved in just such a program at Duke. The idea is that if we can destroy a person’s immune system and then give them a new one from stem cells, perhaps their new immune system will function properly. Here’s the catch. The process of stem cell transplantation doesn’t always work, and perhaps five percent of the people who go through the process will die because of the transplant. At the moment therefore we may have a cure, but for most of the people the cure may be worse than the disease. Such a “cure” might be worth it for the most severely affected individuals, and those will be the ones we anticipate enrolling in a research trial.
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